USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 64
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DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
M R-301
Suffolk
With
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No
186
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 255 Marion St.
(Usual placc of abode)
Length of stay: In hospital or institution
(Specify whether)
years
months
days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
female White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
ingle
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
Years Months. Days
If less than Lday ........ Hours.
Minutes
11 Social Security No.
12 BIRTHPLACE (City Muchos (State or country)
Edward Palumbo
14 BIRTHPLACE OF
FATHER (City)
Everett
15 MAIDEN NAME
OF MOTHER
ER Mary Falconi
16 BIRTHPLACE OF MOTHER (City) (State or country Y Waltham
17 Muitonetta Palumbo Relation, if any (Address) 225 Marion St. EB & mother
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Mr. D. Clickdress.g. (Signature of Agent of Board of Health or other)
Health
9/30/44 (Oinicial Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
MEDICAL CERTIFICATE OF DEATH Cept, 29 1944
Month)
(Day) ( Ycar)
19 I HEREBY CERTIFY. That I attended deceased from Vega 25 19.
... .. to ..
25 19
I last saw had alive on. Soft 29 1944 , death is said
to have occurred on the date stated above, at 5:12am. Immediate cause of death. 7 months Tumature
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease er Injury la any way related to occupation of deceased/
If so, specify
(Signed)
M. D.
(Address)
21 St. Michaelis
Place of Burial, Cremation or Renforal. (City or Town)
DATE OF BURIAL ....
19
4€
,
FUNERAL DIRECTOR
22 NAME OF
Patry Papers
....
ADDR
9 Chelsea St. EBoston
Received and filed 19
CC: 2 1944
A TRUE COPY ATTEST: (Registrar)
1 PLACE OF DEATH 3 SEX (or) WIFE of 8 AGE Usual 9 Occupation: Industry 10 or Business: 13 NAME OF FATHER PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK -- THIS IS A PERMANENT RECORD. Every item of (State or country) 200m-10-'39. No. 8427-d
Hospital St.
(If U. S. War Veteran. specify WAR)
Duration
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required hy section one, where samc was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been huried, until he has received a permit from the board of health or its agent appointed to issuc such permits, or if there is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomh to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have heen de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required hy law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thercof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot he obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such hody shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has heen sooner obtained hcreunder. If the death certificate contains a recital, as required hy section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The hoard of heaith, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can be
ohtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Seo. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall hury a human body or the ashes thereof which have been hrought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be huried or the funeral is to be held, or froin a person appointed to have the care of the cemetery or hurial ground in which the interment Is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside carc during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease un- related to any form of injury, have died without recent medical attendance or whosc physician is ahsent from home when the certificate of death is needed.
(3) Medieal Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .--- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A Suffolk
1
PLACE OF DEATH
County12 Winthrop (City
Winthrop Community Home death
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
187
curred in a hospital give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so speolfy WAR)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
×
months
4
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female White
4 COLOR OR RACE| 5 SINGLE ((write the word)
MARRIED
WIDOWED
Or DIVORCED tatea
2
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if alive 37 yrs years
IF STILLBORN. enter that fact here.
AGE
8 33 Years Months Days
If less than 1 day Hours Minutes
Usual 9 Occuoation :
Industry
10 or Business:
Home
11 Social Security No.
12 BIRTHPLACE (City)
( State or country)
Est Boston
13 NAME OF
FATHER
Carmine Mesullo
14 BIRTHPLACE OF
FATHER (City)
(State or country)
15 MAIDEN NAME
OF MOTHER
Angelina Fenturia
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Informant.
Belation If any Visland
I HEREBY CERTIFY that a satisfactory, standard certificate of death was filed with me BEFORE the burtal er transit permit was issued ?
(Signature of, Agent of Board of Health of other)/ ( health officer 9/30/44
L(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
September 29
/(Month)
(Day)
1944 ( fear)
19 | HEREBY CERTIFY,
That I attended deosased from
YE
to
...
19 ..
Depet 24.
19 44
I last saw % FR
, alive on Lope 29
have occurred on the date stated abova, at.
12 LDA
.m.
Immediate cause of death.
Counte Cardege denizimento
12:15 a
IMPORTANT
Due to./
Rheumatu want disease E
metro atenere D regenzitatio mittene Due to. 26000
Other conditions ...
prequang 8 + woo 0
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy.
What test confirmed diagnosis?
IMPORTANT Physician Uuderfino the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way ralated to oppupation of deceased ?
If so, specify
(Signed)
(Address)
M. D.
21
It michael ten
Place of Burial, Cremation or Removal
DATE OF BURIAL.
Oct 2
(City or Town) 1944 19 .....
22 NAME OF
FUNERAL DIRECTOR ..
tou G. Langung
ADDRESS
to Haverhill
Received and Aled GOT 2 1946 19
( Registrar)
C
Duration
...........
2 hours 14 yr
100M-6 -2-42-8855
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recitai to that effect. PARENTS
No. Carmelas Pasqual
2 FULL NAME ( If deceased 19 married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
49 Byron at least Bestows
19 .. , death is said to
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physioisn or registered hospital medical officer shall forthwith, after the death of a person whoin he has attemuled during his last illness, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnisb for registration a standard certificate of death. stating to the best of his knowledge and behef the name of the deceased, bis supposed age, the disease of which he died. defined as re- quired by section one. where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceiling section or by section forty-Ave of chapter one bundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, served in the army, wavy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the ssine. For neglect to comply with any provision of this section, auch physician or officer shall forfeit ten dollars. For the purposes of this aec- tion and of sections forty-five, forty-six and forty-zeven of said chapter one humulred and fourteen. the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place hetween February fourteenth, eighteen hundred and winety eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or ita agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or otber person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other thau tbe receiving tomb to another In the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the boily is buried. No such permit shall be issued until there shall have been delivered to sucb board, agent or clerk. as the case inay be, a satisfactory written statenient containing the fscta required by law to be returned and recorded, which shall be accompanied. in case of an original interment, by a satisfactory certificate of the ettending physician, if any, as required by law, or in lieu thereof a certifleste as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the aelectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, tbe medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the comunouwealth cannot be obtained early enough for the purpose, the certificate of desth made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten of chapter forty-six, that the deceased aerved in the army, navy or marine corps of the United States In any war In which It has heen engaged. sucb recital shali appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar way require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought hito the commonwealth until he has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk nf the town where the body is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. ... Cbap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy violence. If a medical examiner has notice that there is within his county the hody of such a person, he shall forthwith go to the place where the body lies and take charge of the same ;... - General Laws, Cbap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calls for the observance of the following rules of practice :
(1) Attending phyalcians will certify to such deatha only as those of persons to whom they have given bedside care during a last iliness from disease unrelated to any form of injury.
(2) Board of Health phyalolana will certify to such deaths only as those of persons who, though disahled hy recognized disease unrelated to any form of injury. have died without recent medical attendance or whose pbyaf- cian is absent from home when the certificate of death is needed.
(3) Medlost Exeminers will investigate and certify to all dicatha aup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatism (Including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agenta, aml deaths following abortion, but also deaths from diseaas resulting from injury or infeotlon related to occupation, the sudden deaths of persons not disablad by recognized diseese, and those of persons found deed.
Statement of Ceuse of Death .- Cause of death means the disease, or complication which causes death. not the moile of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualug death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Oooupetlon .- Precise statement of occupation ia very im- portant, so that the relative healthfulness of various pursuita can be known. Make some entry in this section for every persou aged 10 yeara or over. If the occupation had been given up or changed on account of the discase causing death, report the usual occupation prior to illness. If the deceased bad retired from businesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at boine. For a woman wbose only occupatiou was that of hone bousework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook- hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
301 A
1
PLACE OF DEATH -
Suffolk County) Winthrop (City Vanthrop Community /tom! No.
The Commonforalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 188
Registered No.
§ ( If death occurred in a hospital or institution, i give its NAME instead of street aud nuniber)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so speolfy WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: in hospital or Institution
(Before death)
(Specify whether)
years
months days.
In this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX M/ White
5 SINGLE
MARRIED
WIDOWED
( write the word)
Single
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if alive
12 years
> IF STILLBORN. enter that fact here.
8 AGE Years Months Days
If less than 1 day Hours. Minutes
Usual
9 Occupation :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( State or country)
... Winthink grass
13 NAME OF
FATHER
John Pasqua
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston
15 MAIDEN NAME
OF MOTHER
Carmela Merullo
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
East Boston Mais
17 Johna Pasqua
Rotation, if any
Informant 144 Sunat It &B. Hatter
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : Im D. Clubdress
(Signature of Agent of Board of Health or other)
Heath Spiele 9/30/44
........ '(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
( Jfonth )
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deosased from
Est 21
.. ,
19
Lyst 29
19 .. 500
I last saw Fallve on 19 .. ., death Is sald to
have occurred on the date stated above, at 12:20 9.
.
m.
Duration
IMPORTANT
...........
Due to.
Due to
Other conditions.
( Include pregnancy within 3 months of death)
Major findings :
Df operations
Date of.
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify.
('Signed)
(Address) 25%
M. D.
.._...... Date ..
21 Fi michael 6 tem
(City or Town) ... Place of Burial, Creniation or Report DATE OF BURIAL
44 19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
to0 G. Langnot
........
Received and Aled 19 .......
OC 2 1944
( Registrar)
100M-£ - 2-42-8855
@Atrast from file laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physlolans to insert a recital to that effect. perhospital PARENTS
2 FULL NAME
Baby
( If deceased is a married/ widowed or divorced oman, give also maiden nameA 44 Byron Lt 6. Loven
(If nonresident, give clty or town and State)
29
1744
MEDICAL CERTIFICATE OF DEATH
4 COLOR/OR RACE|
(Give maiden name of wife in full)
S
immediate cause of death. Material Death
A
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or regiatered hospital medical officer shall forthwith, after the death of a person whoin he has atteinled during his last illness. at the request of an undertaker or other authorized person or of sns meniber of the family of the deceased, furnisb for registration a standard certificate of death. sisting to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. wlirre same was onutracted. the duration of his last illness, when last seen alive hy the physician or omcer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing s certificate of death aa required hy the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, aerved in the ariny, navy or marine corps of the I'nited States in any war in which it has been engaged. insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the saine. For neglect to comply with sny provision of this section, auch physician or officer shall forfeit ten dollars. For the purposes of thia sec- tion and of sectinns forty-five, forty-six and forty-xcven of said chapter one humulred and fourteen, the word "war" shall include the Chins relief ex- pedition and the Philippine insurrection, which shall, for said purposes, he deenicd to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred and sixtcen and nineteen hundred and seventeen. G. L. Cliap. 46, Sec. 10.
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